special primary election for the same office sought. The Form 501 is considered filed on the date it is postmarked or hand-delivered. Example: Todd Smith filed a Form 501 for the June 2022 primary election as a candidate for county supervisor. Todd Smith was a successful candidate in the June 2022 primary election and advanced to the November 2022 general election ballot. Todd Smith is not required to file a new Form 501 for the connected November 2022 general election since Todd filed a Form 501 prior to the June 2022 primary election for the same office sought.
501
Candidate Intention Statement
CALIFORNIA FORM
Date Stamp
A
For Official Use Only
Check One:
Initial
Amendment (Explain)
1
1. Candidate Information:
NAME OF CANDIDATE STREET ADDRESS Cole, Rayna
EMAIL (optional)
DAYTIME TELEPHONE NUMBER
FAX NUMBER (optional)
(Last, First Middle Initial)
707 555-1235 rcole@gmail.com
) 707 555-1234
CITY (
(
)
STATE
ZIP CODE
1212 Fourth Avenue
CA 95443
Oakmont
DISTRICT NUMBER, if applicable.
OFFICE SOUGHT (POSITION TITLE)
AGENCY NAME
NON-PARTISAN OFFICE
City Council
City of Oakmont
1
PARTY PREFERENCE:
(Check one box, if applicable.) PRIMARY / GENERAL SPECIAL / RUNOFF
OFFICE JURISDICTION
State (Complete Part 2.) City County
20XX
Multi-County:
(Name of Multi-County Jurisdiction)
(Year of Election)
2
2. State Candidate Expenditure Limit Statement:
(CalPERS and CalSTRS candidates, judges, judicial candidates, and candidates for local offices do not complete Part 2.)
(Check one box)
I accept the voluntary expenditure ceiling for the election stated above. I do not accept the voluntary expenditure ceiling for the election stated above. the general or special run-off election. I did not exceed the expenditure ceiling in the primary or special election held on: Amendment:
and I accept the voluntary expenditure ceiling for
(Mark if applicable)
On
, I contributed personal funds in excess of the expenditure ceiling for the election stated above.
3
3. Verification:
I certify under penalty of perjury under the laws of the State of California that the foregoing is true and correct.
[Signature Required]
[Date Required]
Executed on
Signature
FPPC Form 501 (August/2018) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov
(month, day, year)
(Candidate)
Clear Page
Fair Political Practices Commission advice@fppc.ca.gov
Chapter 2.9
Campaign Manual 2 August 2023 Page 135
Made with FlippingBook interactive PDF creator